Forced Ultrasounds for Abortion in Oklahoma – Because Your Government Can Demand That An Object Be Inserted Into Your Vagina

May 5, 2008

I’ll admit that I haven’t been furiously blogging about every single anti-woman bit of legislation to roll through each of the 50 states this year, because there’s simply too much of it, and I generally assume that the most ridiculous of them will never make it out of committee. I also have a bit of fatigue from all of the proposed bills which seem to have as their underlying premise the notion that women are somehow intellectually deficient as a sex, and I think many of the arguments I would make have been reasonably hashed out elsewhere.

There is one recent state law, however, that I feel compelled to point out, even if other bloggers have already thoroughly covered it, because I have readers who aren’t likely to visit many of the feminist blogs where this has been discussed. Late last month, the Oklahoma legislature passed a bill that would require women to have an ultrasound performed prior to obtaining an abortion (and it’s not the first state to do so). The Governor vetoed the legislation, stating that, “this legislation does not provide an essential exemption for victims of rape and incest. By forcing the victims of such horrific acts to undergo and view ultrasounds after they have made such a difficult and heartbreaking decision, the state victimizes the victim for a second time. It would be unconscionable to subject victims of rape and incest to such treatment. Because of this critical flaw, I cannot in good conscience sign this legislation.” The legislature then overrode the veto, making the bill law.

Oklahoma’s Governor, however, missed one crucial element in explaining his veto. The law states that, one hour prior to beginning the abortion procedure, the provider must “Perform an obstetric ultrasound on the pregnant woman, using either a vaginal transducer or an abdominal transducer, whichever would display the embryo or fetus more clearly.”

Let’s just take a moment to get this straight. Sometimes an ultrasound is performed prior to an abortion. Sometimes this ultrasound is a transvaginal ultrasound because it may offer a better view. The exact percentage of times an ultrasound is performed, and how often that ultrasound is transvaginal, is almost irrelevant from one perspective, although early abortions (which most abortions are) will require the transvaginal route. What is relevant is that the law, as written, has no regard for the clinician’s judgment or the woman’s consent – it is aimed only at getting the best picture of the embryo or fetus.

It inserts the government into medical decision-making with no regard for the patient, and is based on the premise that women seeking abortion simply have no idea what they’re doing, and so might need to be informed that there’s actually something in their uterus. I think they know that, or they wouldn’t be at the abortion provider in the first damn place.

This law takes away a woman’s ability to refuse consent to an ultrasound or method of ultrasound and a provider’s judgment about the type of ultrasound needed (and if it is needed) in order to perform a legal medical procedure, for the sole purpose of making sure a woman can see her soon-to-be-aborted fetus, which she likely could have done anyway if she desired – although the law allows her to “avert her eyes.”

But lets get back to the transvaginal vs. abdominal issue. Given the likelihood that the transvaginal ultrasound would “display the embryo or fetus more clearly,” Oklahoma’s legislature has mandated that a woman seeking abortion have an object (what couples blogging about fertility call a “dildo cam”) inserted into her vagina.

Let that sink in. The state has effectively mandated that women seeking an abortion have an object stuck in their vaginas. Whether they consent to that specific thing or not, because they can’t have the procedure they did consent to if they don’t. Whether the provider believes it is medically necessary to stick the object in her vagina or not. Because these women might not know what they’re doing, might need to be emotionally coerced, might be too stupid to understand what an abortion clinic actually does.

I’ve written before about how coerced ultrasounds are a long-standing tactic of anti-abortion activists, who believe that women who see an ultrasound will suddenly *get it* (again, because they couldn’t possibly have known what they were doing) and flee from their decision. As I wrote in the past, “A woman may feel warm and fuzzy at the point of the ultrasound, but that feeling is not going to support her through the pregnancy, is not going to erase poverty, abuse, rape, or health concerns that may cause a woman to choose abortion. It’s not going to help her finish high school. It’s not going to be accompanied by information on all of her options, but is going to be used as part of a campaign to get her to have a baby.” If you think this law has anything whatsoever to do with protecting women in a legitimate way or the legitimate practice of medicine (as performed through abortion services), you have not been paying attention to the political maneuvering going on around this issue. So here we are. Apparently Oklahoma legislators believe coercion is an appropriate use of medical technology, consent be damned, and that effectively assaulting/raping women with an object is an appropriate use of their power.

More commentary on this:
-An ob/gyn notes at Alternet that the fine for not complying is greater than the fine for negligent homicide
-From the same physician as above, a list of what’s wrong with this law
–Amie Newman at RHReality Check says that anti-choice advocates pushing ultrasound measures are “pretending to care about women’s health and well-being when in fact they are using precious legislative, human and financial resources that could be funneled towards laws and advocacy that actually help women; laws that expand health care coverage, protect women from domestic violence, provide needed resources for child-care and more.”
–Lindsay puts it more succinctly than I could: “‘Excuse me, lady, you say you want an abortion. Did you realize that there’s a fetus in there? You don’t know what you’re doing. Let me stick this tube into you, so that you can be competent to make a decision.'”
–Aunt B notes, “If a woman’s boyfriend or husband said ‘If you want an abortion, you have to let me put my dick or my finger or this dildo inside you first, until I’m satisfied you understand what you’re doing,’ we would have no problem–I don’t believe there’s a person reading this who can’t understand how wrong that would be–no problem at all calling that the evil it is, regardless of what you believe about abortion.” Also, please see Bridgett’s comments about cost.

Rachel, what, if any, action has Planned Parenthood taken in Oklahoma regarding this? If a woman goes to Planned Parenthood (let’s just say in Tulsa) for an abortion would PP be forced to give the woman a vaginal ultrasound, even as it is going against their philosophy? (I presume that this law would indeed be against their philosophy.)

Ummm.. how do you think they suck the baby out? Through a woman’s throat? No no, they stick a suction device INSIDE HER VAGINA and dismember her baby. Limb by limb. Then they put tongs IN HER VAGINA and crush the baby’s skull to get its head out. (And that’s for an “early abortion.”) Just like that. I wouldn’t be so worried about a little nosey camera action.

Well, cubegirl, you’re wrong.Thats late term abortion.
I’ve lived in OK and the amount of bible thumping is equal to the amount of adultery, which is why the legislature needed this law.
They don’t know where babies come from. And their wives will all testify they NEED pictures.

Aside from which, cubegirl, consenting to have one procedure, even if both are related to the vagina, does not mean consent for putting anything else in the vagina, especially when the individual is not given the option for separate consent and the provider is stripped of clinical judgement. If you need tubes in your ears, can I go ahead and pierce them too as a condition of getting tubes?

Also note that an increasing number of early abortions are now done medically, which does not require a doctor to insert anything in a woman’s vagina.

I do believe many women are woefully un- or misinformed on the topic of fetal development, and this might inform their personal views on abortion (in either direction). A more informed populace is certainly more likely to make the best decision for themselves, so it would be good to address this knowledge gap.

But why public opinion is that forcing unnecessary medical procedures on women is the best way to address this issue I don’t get. Wouldn’t including the topic of human development in the high school curriculum be more effective? That would find people when they’re not already heavily emotionally invested in a particular decision, plus it would probably influence some people to be more careful with sex because reproduction is such an amazing thing that should not be taken casually. The only conclusion I can come to (as Aunt B. pointed out in her comments) is that the point is not to educate women (or anyone else), but to punish them.

Oh, I never even thought that they would need a transvaginal ultrasound even for a medical abortion. That is horrid.

I am so happy that a similar law was struck down here in Florida. Is the one in Oklahoma the same as the one that was up for a vote here, in which the doctor has to point out the fetal heart tones and read from a script?

It is ridiculous that a woman be forced to have to avert her eyes if she does not want an ultrasound. A woman does not have to have an ultrasound if she has a LIVE birth. Isn’t that a more important decision than having an abortion?

And cube girl, medical abortions do not involve the grisly scene you were described. Neither do early surgical abortions. We are talking tiny amounts of embryonic tissue, not the grisly scene you were so disgusting to describe (and the happy face makes it even worse! ). There are no tongs. There is no head crushing. If you have to lie to get your point across, maybe your debate needs some work.

Cubegirl, “The Silent Scream,” as I understand it, has been pretty widely debunked by scientists – I’ll look for more info and post later. You seem to be willfully missing the point, both here and at Tiny Cat Pants – how you feel about abortion has absolutely nothing to do with whether it is appropriate for the government to mandate procedures against clinical judgment and without specific consent. You seem to simply be parroting the propaganda that “women should be punished, for the baybeez,” without actually addressing the substantial concerns about the law or actual medical/scientific knowledge. I wouldn’t go around inviting people to “do some research” if that were my position. As for canal=canal, I dare you to suggest that a wet willy is equivalent to rape.

Expanded thoughts, now that I’m all showered and coffeed –
The point of the ear tubes/piercing analogy is to illustrate that when one procedure is not necessary for the other, separate judgment and consent is important. Ear piercing is never necessary for insertion of tubes, so requiring it as a condition of the procedure is inappropriate. Likewise, transvaginal ultrasound may or may not be necessary for an abortion, and requiring it as a condition of one is similarly inappropriate, as it removes clinical judgment and a woman’s ability to truly consent. There can be no discussion between patient and provider of “Is this necessary? Is there another way to perform the ultrasound?” because the state has mandated it for reasons that have nothing to do with benefiting either the woman/patient or provider’s ability to perform the procedure.

Women were rightly upset when it was revealed that some institutions were instructing medical students to perform vaginal exams on anesthetized women undergoing gyn procedures. While a gyn procedure generally warrants a pelvic exam, in this case, the women had no ability to consent because they were not aware that the exams were taking place, but this practice was also not providing any clinical benefit to the women. Likewise, an ultrasound may not provide any clinical benefit in some cases, making the mandating of it similarly offensive (although at least women are aware that they’re happening in this case).

I have had a transvaginal ultrasound (in the context of confirming an impending miscarriage). I have had a surgical abortion (the most difficult but right decision I’ve ever made). I was also a rape victim over a span of two years as a preschooler, and have over the years mostly made peace with it.

The ultrasound felt to me very much like rape, especially when they covered the dildo-like probe with a garden variety CONDOM. One issue I haven’t seen raised is whether the woman can at least choose the gender of the ultrasound tech…in smaller communities I bet not. I simply can’t have a male do that exam, at least not without sedation and several counseling appointments after.

The abortion, on the other hand, did not trigger rape memories. None of the instruments happen to resemble a penis. And I can assure any legislators who care to listen that I was very much aware of what was in my uterus, how it got there, and what I was both giving up and gaining in choosing the procedure. 30-some years later I’m proud of the maturity I showed at the time, and pleased with the professionalism of the Planned Parenthood staff who explained ALL of my options and encouraged me to involve my mother.

I am female, a sexual assault survivor, and have had pregnancies end with miscarriage, abortion, and the live birth of 3 wonderful daughters. I also hold a Master’s degree and even find time for a few hobbies. Occasionally a (generally medical) experience triggers unpleasant memories, but most of the time I’m a functioning member of society fulfilling my roles as wife, friend, mother, and professional. How dare a legislature presume I cannot make decisions about my body without pictures to help me understand what I’m about to do, much less pictures that are forcibly obtained from within my own body.

Don’t confuse your odd beliefs about medical procedures with reality. If you want to be taken seriously, it’s best to familiarize yourself a bit with the topic under discussion.

Here’s something to start you off: What is the medical indication for fetal skull reduction, and why is it not applicable to “early abortion”?

Hint: It has something to do with cervical dilatation.

Also, it’s good to know that you won’t be so worried when, for example, your doctor decides to subject you to a rectal U/S, or when your Ob/Gyn decides to abort your pregnancy, without your consent, but most patients would. As would most doctors, when forced to perform invasive procedures on their patients without their consent.

The medical profession has a LONG history of disrespect against women – also, taking advantage of us – power and control, access and opportunity and blatant sexual assault.
It still happens today…
Women in the States are brainwashed into thinking they need annual complete gynaecological exams – does anyone question the need?
In Australia, pelvic exams are not carried out on asymptomatic women – they’re unnecessary and can be harmful. I’m almost 51 and have had ONE in my lifetime. (symptoms)
I’ve read horror stories of girls attending campus clinics and having male doctors forced on them, male students strolling into the exam room unannounced and despite the woman’s objections, doors left open while the woman is exposed, medical students taking turns with the speculum and hurting the patient – many girls are left in tears and traumatized…
It is just horrifying – sadistic and dehumanizing treatment. It astonishes me that sort of things goes on…
Look at the Feministing website where many women relate their stories of medical abuse.
I think Oprah Winfrey should do a show on the treatment of women by the medical profession – she’s a powerful woman that could make a real difference – she’s also, a survivor of sexual assault.
Cancer screening is also, forced on women – pressured and bullied or “required” to get the Pill. Cancer screening has risks and benefits and women should be given full and honest information and left to make their own decisions.
Birth Control has nothing to do with cancer screening.

How can you give informed consent when you’re “required” to have the exam, pressured or given no risk information?
I declined pap smears 30 years ago – as a young lawyer, I did my own research and applied my risk v benefit test – the test failed badly – the risks FAR outweighed the benefits, so I declined screening.
I was unable to get the Pill, so I studied the Billings method – it was a great decision – giving me firm control of my body and health….I couldn’t be forced to have any exam or test.
This Method when used correctly and carefully works very well.

The pap smear is an unreliable test for an uncommon cancer = false positives and negatives & unnecessary and unpleasant colposcopy and possibly, biopsies. Some women are left with permanent damage to the cervix. Risk information is withheld by the screening industry and benefits overstated – it’s basically a scare campaign.
Of course, scare campaigns don’t work when women have the facts…
Did you know that almost 78% of women who have regular screening will have a colposcopy and possibly, biopsies during her screening life, yet only a very small number will have malignancy. (L. Koutsky, Cancer Prevention Fall 2004, Issue 4)

Did you know 1000 women need to be screened for 35 years to save ONE woman from cervical cancer? (Dr Angela Raffles, cervical screening expert) Only 1.58% of Aust. women would get this cancer in an unscreened population.

Did you know that a simple blood test was patented in the States in 2004 that will replace pap smears – the cervical specific antigen? Almost 100% reliable….
Women will have to fight for access – Doctors and pathologists will fight to keep the lucrative and unreliable pap smear and follow-up industry…it’s worth MILLIONS
Women need to demand access asap….

I have recently rejected mammograms – far too much risk. (See articles by Prof Michael Baum)
Women need to make their own informed decisions and demand respectful treatment from the medical provider of their choice.
IMO women have always been treated badly by the medical profession – I thought that might change with more female doctors joining the profession.
The medical barrier to contraception needs to be broken down – world health organizations all say a blood pressure check is the only exam required for the Pill.

It was always explained to me that an ultrasound is necessary for an abortion because the doctor has to make sure the fetus is actually in the uterus where it is supposed to be. I am having a surgical abortion tomorrow morning and I am terrified because I am a rape survivor and I don’t like the idea of having to lay on a table in front of a bunch of people with my legs open and my vagina forced open. I begged for the pill, but they wouldn’t give it to me because I wouldn’t have the money to pay for it in time for the pill to still be an option. I hate this so much… the thought of a transvaginal ultrasound AND a surgical abortion in one day. I don’t know how I will get through it if they are going to make me be awake… and they are. 😦